The MSE should be in the back of one’s mind when performing a Psychiatric History taking exercise.
Note: the MSE should be made up of observations and answers given during the history taking exercise – not based on the history of the patient etc.
The Mental State Examination Consists of:
- Appearance
- Behaviour
- Conversation (Speech)
- Affect (Mood)
- Perception (Thought)
- Thought Form
- Thought Content
- Perception
- Cognition
- Insight
- Judgement
- Rapport
- Memory
Are they dishevelled (may indicate depression, schizophrenia etc) or brightly dressed in outrageous clothes (poor taste in clothes or potentially manic).
Are they clean shaven? Clean? Dressed? Smell?
What is the behaviour of the patient during the interview? Do they make eye-contact? Are the shifty? Do they look agitated or afraid? Is their behaviour appropriate for the interview?
Are there any mannerisms? Is there a problem with their gait?
Is their speech at a normal pitch and speed? Is their speech comprehensible? Is it pressured? Loud? Mumbled?
Affect is what you describe
Is it restricted? Blunted? Labile? Euthymic?
Mood is what they describe
Are they anxious? Depressed? Irritable? Cheerful?
That is…flight of ideas, derailment
Are there delusions? Are they suicidal?
Are there any hallucinations, illusions (eg visual, auditory, gustatory, tactile)
Are they orientated to time place and person?
Are they aware that they have an illness?
Do they show appropriate judgement when asked?
Do they develop a rapport with the interviewer? Are they withdrawn?
Is their short and long term memory in tact?